帕瑞昔布钠辅助硬膜外自控镇痛用于开胸术后镇痛效果观察

Observation on the analgesic effect of parecoxib sodium assisted self-controlled epidural analgesia in post-thoracotomy

目的:观察帕瑞昔布钠用于辅助开胸术后患者硬膜外镇痛的临床效果。方法:68例开胸患者随机分成帕瑞昔布组(P组,n=34)和生理盐水组(S组,n=34),在硬膜外给予罗哌卡因镇痛的同时分别在术毕、术后第12 h静脉注射帕瑞昔布钠40mg或生理盐水4 mL,对患者镇痛效果进行比较。结果:P组内术后4,8 h的HR、MAP明显低于S组(P<0.05),S组4,8,12h的PaCO2值明显高于P组(P<0.05),P组患者术后4,8 h的VAS评分明显低于S组(P<0.05),在4,8,12 h的BCS评分则高于S组。术后24 h内,P组内自控硬膜外给药次数及补使用镇痛不全的补救措施的例数均少于S组(P<0.05)。结论:帕瑞昔布钠静脉注射可对开胸术后采用的硬膜外镇痛起到很好的辅助作用。

OBJECTIVE To observe the clinical effect of parecoxib sodium assisted patient self-controlled epidural analgesia in post-thoracotomy.METHODS 68 cases of thoracotomy patients were randomly divided into two groups,the parecoxib group（group P,n=34） and the normal saline group（group S,n=34）,all patients received epidural analgesia with ropivacaine simultaneously,parecoxib sodium 40mg or saline 4mL were intravenous injected respectively when the surgery was finished and at postoperative 12 h.RESULTS Patients＇ HR,MAP in group P was lowered significantly than the group S at postoperative 4,8 h（P0.05）,PaCO2 in group S was significantly higher than the group P at postoperative 4,8,12 h,（P0.05）,patients＇ postoperative VAS score in group P was significantly lower than the group S at 4,8h（P0.05）,while BCS score were higher than group S at 4,8,12 h.Patients＇ self-controlled frequencies by epidural administration within 24 h after surgery and remedies supplemented cases for incomplete analgesia in group P were less than group S（P0.05）.CONCLUSION Parecoxib sodium intravenously after thoracotomy may be a good assisted contribution in epidural analgesia.